TY - JOUR
T1 - Delivery-to-deliveryweight gain and risk of hypertensive disorders in a subsequent pregnancy
AU - Dude, Annie M.
AU - Shahawy, Sarrah
AU - Grobman, William A.
N1 - Funding Information:
Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2018 by the American College of Obstetricians and Gynecologists.
PY - 2018
Y1 - 2018
N2 - OBJECTIVE: To estimate whether weight gain between deliveries is associated with an increased risk of hypertensive disorders in a subsequent pregnancy. METHODS: This is a case-control study of women who had two live singleton births of at least 24 weeks of gestation at a single maternity hospital from January 1, 2005, to December 31, 2015, with no hypertensive disorder documented in the index pregnancy. Maternal weight gain between deliveries was measured as the change in body mass index (BMI) at delivery. Women who were diagnosed with any hypertensive disorder in the subsequent pregnancy were compared with those who experienced no hypertensive disorder in the subsequent pregnancy using x2 statistics for categorical variables and t tests for continuous variables. Logistic regression was used to determine whether weight gain remained independently associated with hypertensive disorders after adjusting for potential confounders. RESULTS: Of 1,033 women, 188 (18.2%) were diagnosed with a hypertensive disorder in the subsequent pregnancy. Of these, 166 (88.3%) had a hypertensive disorder specific to pregnancy (gestational hypertension; preeclampsia; superimposed preeclampsia; or hemolysis, elevated liver enzymes, and low platelet count syndrome), and 22 (11.7%) had chronic hypertension only. Greater weight gain between deliveries was significantly associated with a higher frequency of hypertensive disorders, which remained significant for a BMI increase of at least 2 kg/m2 in multivariable analyses (adjusted odds ratio [OR] 1.76, 95% CI 1.14-2.74 for 2 to less than 4 kg/m2, adjusted OR 3.19, 95% CI 1.86-5.47 for 4 kg/m2 or more). Conversely, weight loss of 2 kg/m2 or more was associated with a decreased risk of a hypertensive disorder (adjusted OR 0.41, 95% CI 0.21-0.81). CONCLUSION: Among women with no hypertensive disorder noted in an index pregnancy, an increase in BMI of at least 2 kg/m2 between deliveries was independently associated with an increased risk of a hypertensive disorder in a subsequent pregnancy.
AB - OBJECTIVE: To estimate whether weight gain between deliveries is associated with an increased risk of hypertensive disorders in a subsequent pregnancy. METHODS: This is a case-control study of women who had two live singleton births of at least 24 weeks of gestation at a single maternity hospital from January 1, 2005, to December 31, 2015, with no hypertensive disorder documented in the index pregnancy. Maternal weight gain between deliveries was measured as the change in body mass index (BMI) at delivery. Women who were diagnosed with any hypertensive disorder in the subsequent pregnancy were compared with those who experienced no hypertensive disorder in the subsequent pregnancy using x2 statistics for categorical variables and t tests for continuous variables. Logistic regression was used to determine whether weight gain remained independently associated with hypertensive disorders after adjusting for potential confounders. RESULTS: Of 1,033 women, 188 (18.2%) were diagnosed with a hypertensive disorder in the subsequent pregnancy. Of these, 166 (88.3%) had a hypertensive disorder specific to pregnancy (gestational hypertension; preeclampsia; superimposed preeclampsia; or hemolysis, elevated liver enzymes, and low platelet count syndrome), and 22 (11.7%) had chronic hypertension only. Greater weight gain between deliveries was significantly associated with a higher frequency of hypertensive disorders, which remained significant for a BMI increase of at least 2 kg/m2 in multivariable analyses (adjusted odds ratio [OR] 1.76, 95% CI 1.14-2.74 for 2 to less than 4 kg/m2, adjusted OR 3.19, 95% CI 1.86-5.47 for 4 kg/m2 or more). Conversely, weight loss of 2 kg/m2 or more was associated with a decreased risk of a hypertensive disorder (adjusted OR 0.41, 95% CI 0.21-0.81). CONCLUSION: Among women with no hypertensive disorder noted in an index pregnancy, an increase in BMI of at least 2 kg/m2 between deliveries was independently associated with an increased risk of a hypertensive disorder in a subsequent pregnancy.
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U2 - 10.1097/AOG.0000000000002874
DO - 10.1097/AOG.0000000000002874
M3 - Article
C2 - 30204702
AN - SCOPUS:85060802180
SN - 0029-7844
VL - 132
SP - 868
EP - 874
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 4
ER -